5 Patient Safety Measurement Mistakes Hospitals Need to Avoid

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This week, March 2-8, marks the National Patient Safety Foundation's Patient Safety Awareness Week and there are a high number of units in hospitals that do not have a measurement plan to document their performance and help them reach their Key Patient Saftey Goals. LifeWings Partners helps hospitals set effective Key Result objectives to sustain lasting measurable results in their commitment to patient safety.

You would be absolutely shocked at the number of units in hospitals that don't have a measurement plan to document their performance and help them reach their Key Results.

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As a result of the Affordable Care Act there is a focus in America's hospitals on getting real results in patient safety in the midst of treating an increasing number of patients every single day. Medical staffs have huge "change fatigue" just trying to cope with all the changes in health care and trying to focus on taking care of patients. Steve Harden, CEO of LifeWings patient safety consulting firm, offers strategies for setting Key Result objectives for patient safety that will achieve lasting measurable results.

Harden says that, "You would be absolutely shocked at the number of units in hospitals that don't have a measurement plan to document their performance and help them reach their Key Results. Without a scoreboard, how do you know if you are winning? More importantly, how does your staff know they are winning?"

Mistake #1: Not having a measurement plan at all.

Not having a scoreboard keeps hospitals and staff in the dark about where they are succeeding and where they need improvement.

Mistake #2: Not sharing the results of the measurement plan with your staff.

Mr. Harden says, "if your unit reaches the desired Key Results it's because your staff performed the right actions on a daily basis. If they don't know the goal, it's impossible for them to adjust their daily work to reach the goal. Again, if you could walk a mile in my shoes as I perform site assessments around the country, you would be shocked at the number of times I discover that frontline staff have no idea what the key measure for safety or quality performance is for their unit."

Steve says a good way to test this is to round with your staff for 20 minutes and ask everyone you see, "What is our main measure for our patient safety (or quality) success this year, and what is the main action you should be taking every day that will help us reach that goal? If there is no alignment on the answers to these questions, it's clear there is a need for a transparently visual measurement plan and daily scoreboard."

Mistake #3: Too many goals in your measurement plan.

Make sure the team is all working toward the same goal. With this in mind, Steve paints this picture, "Imagine the list of the Key Results in your measurement plan as a 10-ton boulder. To move the boulder, you'll need all of the team to get on one side of the boulder and push together in the same direction at the same time. In other words, alignment is critical."

It is much easier, and more effective to get alignment around a much smaller list; that way there is no confusion about what is important, and it's easier for staff to self-direct their daily activities to reach the Key Results. Fifteen Key Results is too many, and the staff will be pushing in all directions and the boulder will never move. Harden believes from his experience working with hospitals that having no more than three to four Key Results are more effective for getting alignment.

Mistake #4: Not selecting the right Key Results.

To arrive at the best Key Results when LifeWings works with hospitals, one of the exercises in the Leadership Development workshop is to ask the leadership change team to answer this question, "If every other aspect of your operations held constant, what one thing, if significantly improved, would provide the greatest safety benefit to your patients?"

The answer to this question becomes the number-one desired Result. Next, assume that Result is achieved, then ask the question again. The answer to the second time you ask the question becomes the number-two desired result. Ask the question a third, and even a fourth time if needed. Stop there. These are the Key Results that every activity in the initiative should be aimed at achieving.

Make sure the three or four Key Results chosen for the measurement plan are actually Level 4 Results or "Outcomes." For example, in an ICU, the goal of "Reducing a CLABSI rate" is an "outcome" measure. The Key Result of "Improving hand hygiene" is a Level 3 Result or "Behavior/Action." Setting a Level 4 Result as the main target and hitting it is much more motivating for the staff than meeting a Level 3 Result. Setting the right Level 4 Result will dramatically increase the odds of success.

“Measurement is the first step that leads to control and eventually to improvement. If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.”
― H. James Harrington

About LifeWings:
LifeWings Partners, LLC is a team of physicians, nurses, Toyota-trained Lean experts, health risk managers, astronauts, military surgeons, and flight crews. Our team was the first in the United States to study the best practices of organizations with high reliability, and successfully adapt their strategies for use in healthcare. We have distilled the methodology used in commercial aviation, military aircraft carriers, nuclear submarines, and cutting-edge manufacturing to assist healthcare organizations create safe, efficient, and high quality hospitals and clinics.